April 16, 2025 • 29 mins
Welcome back to Plastic Surgery Uncensored. We’ve arrived at Part 3 of our deep-dive into non surgical treatment series and this one’s a game changer. In this episode, Host Dr Rady Rahban sits back down with his incredible aesthetic nurse Charlene to talk about lasers—not the fantasy, not the fluff, but the facts. Think lasers are one-size-fits-all? Think again. From pigment correction to skin resurfacing and hybrid treatments, we’re breaking down exactly what works, what doesn’t, and how to avoid the all-too-common pitfalls patients face when chasing results at under-supervised med spas. We’re unpacking:
🎯 Bottom line: There’s no such thing as a miracle machine. Lasers are only as good as the provider behind them—and the plan in place. So if you’re curious, skeptical, or just laser-curious, this one’s for you.
Subscribe, share, and leave a review if you’ve been loving the series. You might just save someone from a very expensive mistake.
- The difference between BBL, TRL, and Halo—and why they’re not interchangeable
- What can go wrong—burns, pigment issues, cold sores—and how to avoid them
- Why proper skincare before and after treatment is non-negotiable
- And how stacking treatments (with downtime or not) can maximize your results
🎯 Bottom line: There’s no such thing as a miracle machine. Lasers are only as good as the provider behind them—and the plan in place. So if you’re curious, skeptical, or just laser-curious, this one’s for you.
Subscribe, share, and leave a review if you’ve been loving the series. You might just save someone from a very expensive mistake.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:06):
All right, welcome to another episode of Plastic Surgery and Censored.
I'm your host, doctor Roddy Rabon, and we are part
three of a multi part series. Here with Charlene are
wonderful aesthetic nurse, and our goal was to create a
series of episodes that focus exclusively on the non surgical
(00:26):
MEDSPA world. Everyone that follows me and knows me knows
I'm sort of very I don't like the word anti
because obviously I'm not anti because we haven't met SPA.
I'm very cautious about the MEDSPA world. The reason I
have been is because I think it's an environment that's
generally very unregulated and very wild wild West. I think
that's an area where consumers are exposed to more wrongdoing
(00:49):
than others because there's less information and the philosophy. Oh
it's just minor. I just walked in. It's no big deal.
So the reason Charlene and I get together is to
create this sequel. We did one on neurotoxins like botox,
we did one on filler, and this episode is going
to predominantly be pretty much about lasers. So interestingly enough,
(01:13):
if you would have spoken to me last year and said, hey,
what are your thoughts on lasers? I tell you I
have no thoughts. Yeah, because I knew nothing about lasers.
I knew that just about lasers. But like everything else,
I'm a very big believer that if you offer something
to a patient, you should really know what the hell
you're talking about. Yeah, of course, right. No, So many places,
(01:37):
the medical director, the doctor is offering treatments they know
nothing about, and they just have them there, and the
machines run or the nurses are doing things and the
doctor a because they're a pediatrician, be their radiologists see,
they don't have a clue, they don't care, they're not there.
So for me, because of the nature of who I am,
(01:58):
when I decided that we were going to build this
wellness slash METS aesthetic METSPAS center together, it was imperative
that I knew what I was talking about. And so
obviously I'm incredibly familiar with neuromodulators and fillers, and laser
was a whole new area for me. So I did
a ton of homework by myself, a ton of homework
(02:20):
with colleagues and dermatologists that I knew, picking their brain
as to why do you have this one? Why do
you have that machine? And like everything else, there's a
thousand options. It's like saying, hey, I knew nothing about cars.
I went to go buy a car, and I was like, whoa,
there's like a thousand different cars out there. There's a Mercedes,
there's a BMW, there's a Porter, there's a Lamborghini, there's
a Volvo. Like, how do I know? It's the same thing.
(02:43):
So the way I the thing I want people to
understand about lasers is laser is a very very very
broad term. It means nothing in that you can have
a laser whose wavelength which we're going to elaborate on
in a second, is designed exclusively towards hair. Yeah, and
(03:09):
it will do nothing for your sun spots. And you
can have a laser who only works sunspots and do
nothing for your hair. Yet they're advertising this as a laser.
So why many patients have been disenchanted by lasers historically
is as a provider here, doctor Rabond, I buy this
(03:31):
really expensive laser, and I wanted to do as much
as possible as possible, and I then market it as
doing hair removal, veins, skin resurfacing. La la la la
la and obviously it's it's just impossible for it to
do that. So the basic principle of all lasers is wavelengths, right,
(03:53):
So why don't you, because you have a lot of
experience with lasers, explain this whole concept of wavelengths and
how it targets different things in the skin.
Speaker 2 (04:02):
Yeah, So essentially, there's different wavelenks with the laser, and
the wavelength is kind of the time that it takes
for the energy to go in and out of the
skin tissue. So different wavelengths can target different issues or
concerns that you have. There's wavelengths to help with redness,
so any sort of vessels, rosation, any sort of you know,
broken blood vessels and things like that. We have wavelengths
(04:24):
to help with pigmentation, dark spots, sunspots, issues in that manner.
And then we have lasers that can help with texture,
so fine lines, wrinkles, pores, scars, you know, we have
different ones, and we really wanted to break it down
to address those two main components pigment and texture.
Speaker 1 (04:42):
Right, So why I want you to pay attention is
each laser, you need to know what that laser was
designed to target. So let me explain why this is. So,
if you go into a spa and your goal is
to get sunspots removed, you need to ask them before
you go in, what laser are you using. We're using
(05:06):
a Syton laser. Great, what's the wavelength that they're using?
Then you before you go in, you google that and say,
does this laser with that wavelength address the thing that
I'm going in for? Because all too often what happened
just patients call and say, hey, I have some sunspots, Like,
come on in, we have a laser. You go in,
(05:26):
they numb you up, they zap you, and you leave.
What laser do you have done? I don't know. What
was a wavelength? I don't know? And then how did
it go? Mm? Wasn't that effective? Well? Yeah, because you
use a screwdriver to put in a nail, Like, that's
not what it was. But it was a laser. Again,
lasers are so specific, so you really really important that
(05:49):
you know that. In my quest obviously, in my quest, obviously,
my goal was to address the things that I think
were helpful in a surgical practice. Right, like my goal,
you can go get hair removal. Great, there are lasers
that are super good at hair removal. You have lasers
that remove tattoos. You have lasers that, as you said,
(06:11):
get rid of vessels and spider vessels and you know, uh,
spider angiomas and things like that. You have vessel You
have lasers that resurfaced your skin and take off a
layer of it. Our goal at our METSPA, or our
goal in our wellness center, was to provide something that's
(06:33):
adjunctive to a surgical practice. So the reason why I
think it's so critical is that we have a met
SPA where I'm the medical director, right, I am the
one who is with you, curating the treatments we provide,
making sure it's the best treatment technologies, making sure the
results are being held to the same standards that you
(06:54):
would want when you come get a facelift or rhinoplasty.
Where I run into trouble is that the majority of
metz spas are isolated by themselves. The medical director is
there once in a blue moon, They're not in the
specialty of this. They're like an ob who is helping
out a friend, and often the nurses and providers are
(07:15):
sort of just figuring out things on their own. I
think those are distinctly different than those that are provided
under the umbrella of a surgeon who does esthetics totally
two different animals. So at any rate, in looking for
a laser, the things that I wanted to address were
the things that I thought that here you come in.
Patient comes in, she's in her late forties, fifties, maybe sixties,
(07:39):
once facial rejuvenation, like, hey, you know it's time. I
think it's time. My eyelids are starting to get a
little excess. I got some sagging, I got a little jow,
little neck band, and they wanted a rejuvenation. And despite
being a great surgeon, there's just certain things I can't do.
I just can't do it. What do you mean you
can't do I can't change the quality of your skin.
(08:02):
I can change the gift. I can change the gift wrapping.
And so I had reached a level now that my
practice is so much heavier in esthetics, facial aesthetics, that
is it would be. It was frustrating not to be
able to provide the totality of what I think a
patient needs in order to get a home run result.
(08:25):
You could do a facelift, you could do their eyelid,
you can do whatever, and then they'd look good, but
they still have crappy skin, they still have a bunch
of sunspots and sun damage. So the areas that we
focused in on is we here in in our met
spot focus on predominantly sun damage right, pigmentary related sun
(08:50):
damage types of things all the way down to melasma,
which technically isn't sun damage but hormone driven, as well
as skin texture, wrinkles, resurfacing pores, things of that nature.
We dabble in the vessels and suns, the rosetia thing
because the laser we have is so broad, but generally
(09:13):
that's the bulk of it. And so after extensive homework,
it became apparent to me that the laser that we
ultimately acquired, in my opinion, currently, as you know, with
the technologies, it's constantly going to change. But I think
that the laser that we got is the Bugatti of lasers.
(09:35):
And why that is is because number one, I think
that consistency of results, meaning it consistently produces fantastic results.
Number Two, it allows us to treat more patients than normal.
So you and I talked about this. A traditional laser
(09:55):
laser energy coming out of a machine was designed for
white people. Not let me rephrase that. It wasn't designed
for white people. It was just that white people were
the only people that could do it. It wasn't like
they went out of their way and they were like, racist,
I'm gonna make a laser only for the white folk. No,
it was just that the technology, because it's heat, only
(10:17):
white skinned people could take advantage of it, because darker
skinned people like me, like you, like Latinos, like African Americans,
like Indies couldn't because they would create a host of
new problems. And so as a result, let's go over
skin coloring. The whole spectrum of skin colors is designed
(10:38):
by is categorized by a term Fitzpatrick. I'm assuming it
was doctor Fitzpatrick. I'm assuming, and we call it Fitzpatrick
scale from one to six. One being snow white, six
being African black. Right, So one, two and some threes
have always been able to do lasers, four five, six
(11:02):
never been able to do lasers. And because my practice
is so heavy in four fives and six is right.
We have Asians, Middle Easterners, Latinos, African Americans, people that
are of Indian descent. I mean shit, eighty percent of
(11:23):
my patients are kids Fitzpatrick four five and six. So
the current technologies in most companies, their lasers don't really
can't really treat four five and six. They just haven't
gotten there. The laser we ultimately decided on, which is
(11:43):
a Syton laser. This is not an ad for Sitan
is really the only one of the only laser companies
that has advanced the technologies such that darker people can
benefit from these lasers. And I think for me, as
a person who has never had a laser, this is
(12:04):
the best time to enter because I now have acquired
a laser that I can do a lot with the
patients that we have. So in the Syton laser world,
they have many lasers. We went ahead and selected what
we felt were the three most critical lasers and we're
going to talk about what they do and who they're
(12:25):
for and what to look for and whatnot. One of
them is a technically not a laser. Yeah, it's called
BBL and I'm not talking about Brazilian butt lifts. It
took me a while. I was like, what butt lifts
are getting into lasers? So Brazilian butt lift slash BBL
is broad band light and what people will know it
(12:48):
as is IPL right, intense pulse light, And what you
had told me about it is that it's just a
flash of light that goes straight through the skin, finds pigment,
explodes pigment, and then the pigment finds its way to
the surface. So historically it was done with IPO, and
(13:09):
Syton came up with their own technology of the in
the intent in the light technology. They renamed it as
broadband light, essentially the same as an IPO. But now
you can start treating higher Fitzpatrick and I think that's
a game changer, right, So tell me about yours. You're
(13:30):
a lighter eight, you're a lighter Asian woman, but you're still.
Speaker 2 (13:34):
A four and I'm still four.
Speaker 1 (13:36):
Exactly what makes you a four is what.
Speaker 2 (13:39):
Well my Asian descent and I'm Filipino, so that in
general we do have more melanocytes in our skins.
Speaker 1 (13:44):
Right, the tanning potential exactly, So people that are white
that tan are not white. That's the key. White means
that when you go to in the sun, you have
no melanocytes, you get red and beat beat, red, lobster,
red peel, and you just don't when you're whitish, and
you go in the sun and you get darker and
(14:05):
you get freckles, then technically you're not a one or two,
you're like a three four. So Charlene's a four, I'm
probably a four, which means that if you know, we
went to you know, Costa Rica for a month, we
probably much darker now you can you and I can't
really do IPL no, And I've.
Speaker 2 (14:23):
You know, I've worked with lasers for maybe fifteen years
and I've tested and IPL myself. I would give myself
a little testpot just to see if I could even
do it, because obviously I want to get the benefits
for a machine that I'm using on other patients. And
I have had some hyper pigmentation and burned from it.
Speaker 1 (14:38):
Yeah, even with the.
Speaker 2 (14:39):
Lowest settings and the safest settings that I think I
could use.
Speaker 1 (14:42):
Yeah. So I think that's the reason why their BBL,
their broadband light siitons is such a game changer, because
you can't treat fives, you can't treat sixes, yeah, but
you can pretty safely address three fours and some five
lighter five, right, And that's that's that's kind of like
(15:03):
synonymous to autonomous driving cars like it's a big leap
in the laser world, wouldn't you say? Yeah?
Speaker 2 (15:09):
Yeah, they were able to integrate these different filters that
can you go to use it with other skin.
Speaker 1 (15:16):
Types, right, So I think that's really really remarkable. So
of course we got that it's not a laser, but
that mode mode. The next mode was we wanted something
that would resurface. Right. So here you are, you come
in for a facelift. You're in your late forties, early
fifties and sixties and beyond, and we're going to tighten
(15:38):
up your skin and pull it and make it snug.
But your skin has now had fifty years of road rash, right,
It's got pores and fine wrinkles in whatever, and so
a perfect time for us to resurface your skin, clean
off the top layer depending on your tolerance. Your tolerance
is during the OAR and so there are two main
(16:01):
technologies CO two resurfacing and erbium resurfacing, Buy and large.
For the average consumer, they're the same, YEA. What that
means is they're ablative, meaning they are burning, burning layers
of skin off. And the laser is so advanced that
(16:22):
I can dial it in by micro nanometer micron microns
and dial it in layer by layer. I'm talking ten
microns one hundred microns, which is insane because it means
that the laser can take a little of the layer off.
And why this I chose the erbium version. Their name
(16:43):
is trol. It just is an erbium resurfacing laser. And
what I love about this laser is that it allows
me to do a you're under anesthesia, you're asleep, you
have no pain, you can't feel nothing. I'm going to
crank up this resurfacing and I'm going to burn the
(17:05):
outer layer of your face off. And the benefit is
A you can tolerate it, because normally you wouldn't be
able to tolerate such a deep resurfacing, and b is
you're down for the count because the number one issue
with all lasers is recovery. So the more aggressive we get,
(17:25):
the more amazing the results, the more downtime you have.
And so when you're having surgery and you're out for
sure for at least a week, we have the luxury
of having downtime. So I am now not only doing
this resurfacing on all my facelip patients. I'm doing this resurfacing.
(17:46):
I did a Mommy makeover on Friday, I resurface the
shit out of her face because frankly, she has no
pain when she's on anesthesia and she's out for a week.
So it's been a game changer in that regard. But
the reason I love this laser is because in addition
to being in the OAR and major downtime and major
(18:06):
outcome is we have a milder versions that you are
now able to do in the clinic with less downtime,
almost no pain, less recovery, and higher skin types. So again,
I think the laser, this particular laser, the Syton laser,
(18:29):
was a game changer because it started giving us tools
to help with all the patients I never were to
be able to. So the two types of peals that
we can sorry, excuse me, the two types of resurfacings
we can do in the clinic side is something that
we just refer to as a nano peal, aka a
very gentle resurfacing, which we can do in black patients that.
Speaker 2 (18:53):
Is nuts properly pre treated.
Speaker 1 (18:56):
Right, We're going to get to the pre treatment and
then we can do something called the micropeel, which is
a more aggressive form which would which we can also
do in certain types of people. So A, we got
the BBL pigment. B we got the resurfacing, which was
a TRL. Now the final game changer was this thing
(19:17):
where now we have what's called a halo. And the
reason the halo is a game changer is it's a hybrid.
It literally takes both of those technologies and wraps them
into one. And what it allows you to do is
sends two wavelengths simultaneously. In one is it penetrates deep
zaps the pigment like the BBL but different, and then
(19:41):
at the same time it resurfaces the top. So in
one treatment with the halo, you get the benefits of
pigment and the resurfacing. And that one is right now
probably the hottest laser on the market. There used to
be a laser Cullt not used to there still is.
There's a laser called Fraxel and Fraxol is the laser
(20:04):
that originated this concept and they were the og of
this technology and for many years they were the main thing.
Like anyone who wanted to get resurfacing of their skin,
they were, you know, in their forties and fifties, even
in their late thirties they'd go get a fraxel. This
(20:24):
technology really is the new iteration and blows the fractional.
Speaker 2 (20:28):
So this laser apart though, is that with the fraxol,
I mean, it is a great technology and you could
still use it today, but you were limited to the
skin types that you had to use it on. You
couldn't treat fives and sixes with that, yeah, maybe even fourst.
But with the halo we can actually even treat up
to a six skin type six yeah.
Speaker 1 (20:45):
Which which again for anyone in the laser world, I
think this idea of even treating darker skinned people is
just like Wow, this is such a game changer. Literally,
it's like it's a revolution in my opinion. So essentially
what we did was we acquired these three modalities. We
have a pure pigmentary light based laser BBL, which we
(21:11):
have a true resurfacing layer that a laser that we
can do from mild moderate severe, oh my god. And
then we have this incredible hybrid laser that we can
do both in one shot. You can do these lasers
in the clinic under numbing cream and you can do higher,
more aggressive ones in the oar under anesthesia. The other
(21:34):
thing about it. That's really cool is that you know
you can stack these treatments so like you can do
a nanopeal and a BBL in one setting and they
work completely differently, and they almost mimic a halo.
Speaker 2 (21:50):
It's for the people who want less downtime. I'd say, yeah,
obviously have to do more sessions than a halo, but
you'll have very little downtime but still get results.
Speaker 1 (22:01):
Yeah. So the key to lasers in general, what I
want you guys to understand first. First thing is I
need to make sure I'm using the right laser for
the right problem. So if you don't know what your
issue is it's pigment, it sprinkles, it's vessels, and you
don't identify that the laser that the place is using
is the best laser for that problem, don't bother going in.
(22:21):
The Next thing you need to decide is how much
downtime am I willing to have? How much downtime am
I willing to have? Understand, more downtime equals better results
the end, there is no laser amazing results zero downtime
that just doesn't exist. The greater the downtime, the better
(22:44):
the results. So your options are a suck it up.
I'm going to take a week off. I'm off for vacation.
My kids are this. I broke my leg. I'm going
in for a breast dog whatever. Go more aggressive, be
done with it, and or I don't have that such luxury.
I work my kids. Do da da do more sessions?
(23:04):
Get there anyways and have lesser down time. Do you
only downside to the more sessions? It's it's more sessions.
The upside is that you don't lose. You don't lose
a beat. Now, the next thing that I think is
super important is that without skincare, do not do lasers.
(23:27):
Without skincare, do not do lasers. I am a prime example.
I did lasers. I did it without skincare. I kind
of was being a little bit of a cavalier and
it didn't work out as well as I like. Because
at the end of the day, I'm still a Fitzpatrick. Four.
I still go outside. I need Thistat the other if
you are white and you are fitzpactors one and two,
(23:49):
you are lucky. You don't need anything. If you are
everyone else in the world three, four, five, six. If
you go in and you just go into a spa
get a laser done to your face and walk out,
you are likely to have more pigment, more sun spots,
more irregularities. Did you hear what I just said? Because
(24:10):
these things are heat driven, and if you don't do
the pre and post skin care, if you are not committed,
if you don't have the whatever it takes, then don't
bother because you have to get the skin ready to
get heated, and then you need the skin to be
treated after it's been heated. Now, it's very mild, it
(24:33):
doesn't take a lot. It's not a major to do.
It's not a huge ordeal. But like, you can't have
a laser and not worse SPF. You just can't. Like
you just forget it, don't go. It's a waste of time.
Not only is a waste of time, I actually think
you get worse. Yeah, you know there's people who have
gone and gotten lasers and then they've gone on vacation
or something and then they're like sunspots that I actually
(24:55):
when I was twenty something, I went in I had
like five hairs on my back and I had my
laser I had. I went somewhere I had my back
hairs lasered off. I was like, oh cool, because my
friend is an idiot and he took me with him
and he's a hairy bear and he lasered his back.
And then like two weeks later we went to Vietnam
and like beach cities. The amount of freckles on my
(25:19):
back right now, actually, as a matter of fact, you
got to be beyond my back. The amount of freckles
on my back is insane. And that was my stupidity.
I didn't use any SPF. So and then that's really
really really important. What can go wrong with lasers. Let's
talk about what can go wrong with lasers.
Speaker 2 (25:36):
So, again, if you're not properly using the proper skincare,
pre treating, post treating, you can definitely get your results
can be worse.
Speaker 1 (25:45):
Pigment, your pigment can skyrocket. Pigment can skyrocket. If you
went in there fix your pigment and you don't get
the right settings, the right pre treatment, the right post treatment,
your pigment could get worse.
Speaker 2 (26:01):
You could get a burn burn.
Speaker 1 (26:04):
So if you are oh, I've been on retinee all
day long, I I you know, you're an acutaine or something,
and you go in there and you get lasered and
you your skin is thin, you can get burned, or
the setting is too high, you can get burned.
Speaker 2 (26:19):
Yeah, absolutely, cold source, cold source.
Speaker 1 (26:24):
So if you are prone to cold source, it's not
a complication, but it's certainly not going to be fun.
And if you get a shingles outbreak, you'll be pissed.
So if you are prone to cold source, any type
of stress, as you know, stress of a flu. I
got COVID. I'm undergoing of divorce triggers these viruses. So
you want to make sure you tell your provider. Hey,
they should be asking you anyways, but hey, I get
(26:46):
cold source, you should take a Voaltrex and a few
and a little bit of medication for a day or
two around the lasers. Those are really the two main
things I think you can get pigmentary changes or burns.
It's pretty much the main, main main issues. We're very
excited about our new laser. To me, it's almost like
(27:07):
it's exciting because it's things that I was never able
to do. And I think that it really is a
cherry on top and this sort of if you will,
the hood ornament on a rolls or a Bentley without it,
it's just sort of an incomplete process. And I'm very
excited that we're able to do this and do it
at a high level now. So listen, we happen to
have this Syton laser. It's not to suggest that other
(27:29):
laser is not good. There's actually a ton of other
great lasers. You just need to become educated. And I
it took me a while to become educated, but I
now know like a Pico Shore, a Piko Shore specific
for this. I want to get my tattoo removed. I
would google best removal tattoo remove a laser, and they
each laser will have a will be really honed in
(27:50):
to do one very specific thing. One thing is for sure,
no laser does it all like there isn't one hand
piece with one wave length. Then you just go in
there and zap off your hair, remove your tattoo, get
rid of suns. It just doesn't work that way. By
the way. Also, we talked about just briefly, and I'll
just touch on this because no, actually we'll do this
(28:12):
in another episode. I was gonna talk about micro needling,
but we'll talk about our f microneedling. But we'll talk
about that on micro needil at any rate, I hope
you found that to be informative. Obviously, it's a very
superficial crash course on lasers. It's sort of what I
think would be relevant for you to know, and hopefully
it was helpful. We're gonna do Our next episode will
(28:32):
be on micro needling, which, if you talk to my wife,
is the wife and charlene favorite treatment in the whole universe.
I would argue that it truly is, and we'll touch
on this whole new world of radio frequency micro needling,
which is RF and things like Morpheus. So anyway, I
hope you enjoyed that episode. As always, two parting favors. One,
(28:55):
if you like the show, go write something sweet, Go
write a review, Go say hey, it was great and
we really do appreciate it. Secondly, send our episode, Send
it to friends, family members. You never know who's gonna
go and do something stupid and foolish and you're like, oh,
I just listened to an episode. I wish you would
have listened to it. You just don't know what's gonna
(29:16):
happen to someone you love, So share, subscribe, and download.
All right, that's a wrap, yet another episode of plastic
surgery and sense it. We'll see you next week. Your host,
doctor Roddy Raban,
All right, welcome to another episode of Plastic Surgery and Censored.
I'm your host, doctor Roddy Rabon, and we are part
three of a multi part series. Here with Charlene are
wonderful aesthetic nurse, and our goal was to create a
series of episodes that focus exclusively on the non surgical
(00:26):
MEDSPA world. Everyone that follows me and knows me knows
I'm sort of very I don't like the word anti
because obviously I'm not anti because we haven't met SPA.
I'm very cautious about the MEDSPA world. The reason I
have been is because I think it's an environment that's
generally very unregulated and very wild wild West. I think
that's an area where consumers are exposed to more wrongdoing
(00:49):
than others because there's less information and the philosophy. Oh
it's just minor. I just walked in. It's no big deal.
So the reason Charlene and I get together is to
create this sequel. We did one on neurotoxins like botox,
we did one on filler, and this episode is going
to predominantly be pretty much about lasers. So interestingly enough,
(01:13):
if you would have spoken to me last year and said, hey,
what are your thoughts on lasers? I tell you I
have no thoughts. Yeah, because I knew nothing about lasers.
I knew that just about lasers. But like everything else,
I'm a very big believer that if you offer something
to a patient, you should really know what the hell
you're talking about. Yeah, of course, right. No, So many places,
(01:37):
the medical director, the doctor is offering treatments they know
nothing about, and they just have them there, and the
machines run or the nurses are doing things and the
doctor a because they're a pediatrician, be their radiologists see,
they don't have a clue, they don't care, they're not there.
So for me, because of the nature of who I am,
(01:58):
when I decided that we were going to build this
wellness slash METS aesthetic METSPAS center together, it was imperative
that I knew what I was talking about. And so
obviously I'm incredibly familiar with neuromodulators and fillers, and laser
was a whole new area for me. So I did
a ton of homework by myself, a ton of homework
(02:20):
with colleagues and dermatologists that I knew, picking their brain
as to why do you have this one? Why do
you have that machine? And like everything else, there's a
thousand options. It's like saying, hey, I knew nothing about cars.
I went to go buy a car, and I was like, whoa,
there's like a thousand different cars out there. There's a Mercedes,
there's a BMW, there's a Porter, there's a Lamborghini, there's
a Volvo. Like, how do I know? It's the same thing.
(02:43):
So the way I the thing I want people to
understand about lasers is laser is a very very very
broad term. It means nothing in that you can have
a laser whose wavelength which we're going to elaborate on
in a second, is designed exclusively towards hair. Yeah, and
(03:09):
it will do nothing for your sun spots. And you
can have a laser who only works sunspots and do
nothing for your hair. Yet they're advertising this as a laser.
So why many patients have been disenchanted by lasers historically
is as a provider here, doctor Rabond, I buy this
(03:31):
really expensive laser, and I wanted to do as much
as possible as possible, and I then market it as
doing hair removal, veins, skin resurfacing. La la la la
la and obviously it's it's just impossible for it to
do that. So the basic principle of all lasers is wavelengths, right,
(03:53):
So why don't you, because you have a lot of
experience with lasers, explain this whole concept of wavelengths and
how it targets different things in the skin.
Speaker 2 (04:02):
Yeah, So essentially, there's different wavelenks with the laser, and
the wavelength is kind of the time that it takes
for the energy to go in and out of the
skin tissue. So different wavelengths can target different issues or
concerns that you have. There's wavelengths to help with redness,
so any sort of vessels, rosation, any sort of you know,
broken blood vessels and things like that. We have wavelengths
(04:24):
to help with pigmentation, dark spots, sunspots, issues in that manner.
And then we have lasers that can help with texture,
so fine lines, wrinkles, pores, scars, you know, we have
different ones, and we really wanted to break it down
to address those two main components pigment and texture.
Speaker 1 (04:42):
Right, So why I want you to pay attention is
each laser, you need to know what that laser was
designed to target. So let me explain why this is. So,
if you go into a spa and your goal is
to get sunspots removed, you need to ask them before
you go in, what laser are you using. We're using
(05:06):
a Syton laser. Great, what's the wavelength that they're using?
Then you before you go in, you google that and say,
does this laser with that wavelength address the thing that
I'm going in for? Because all too often what happened
just patients call and say, hey, I have some sunspots, Like,
come on in, we have a laser. You go in,
(05:26):
they numb you up, they zap you, and you leave.
What laser do you have done? I don't know. What
was a wavelength? I don't know? And then how did
it go? Mm? Wasn't that effective? Well? Yeah, because you
use a screwdriver to put in a nail, Like, that's
not what it was. But it was a laser. Again,
lasers are so specific, so you really really important that
(05:49):
you know that. In my quest obviously, in my quest, obviously,
my goal was to address the things that I think
were helpful in a surgical practice. Right, like my goal,
you can go get hair removal. Great, there are lasers
that are super good at hair removal. You have lasers
that remove tattoos. You have lasers that, as you said,
(06:11):
get rid of vessels and spider vessels and you know, uh,
spider angiomas and things like that. You have vessel You
have lasers that resurfaced your skin and take off a
layer of it. Our goal at our METSPA, or our
goal in our wellness center, was to provide something that's
(06:33):
adjunctive to a surgical practice. So the reason why I
think it's so critical is that we have a met
SPA where I'm the medical director, right, I am the
one who is with you, curating the treatments we provide,
making sure it's the best treatment technologies, making sure the
results are being held to the same standards that you
(06:54):
would want when you come get a facelift or rhinoplasty.
Where I run into trouble is that the majority of
metz spas are isolated by themselves. The medical director is
there once in a blue moon, They're not in the
specialty of this. They're like an ob who is helping
out a friend, and often the nurses and providers are
(07:15):
sort of just figuring out things on their own. I
think those are distinctly different than those that are provided
under the umbrella of a surgeon who does esthetics totally
two different animals. So at any rate, in looking for
a laser, the things that I wanted to address were
the things that I thought that here you come in.
Patient comes in, she's in her late forties, fifties, maybe sixties,
(07:39):
once facial rejuvenation, like, hey, you know it's time. I
think it's time. My eyelids are starting to get a
little excess. I got some sagging, I got a little jow,
little neck band, and they wanted a rejuvenation. And despite
being a great surgeon, there's just certain things I can't do.
I just can't do it. What do you mean you
can't do I can't change the quality of your skin.
(08:02):
I can change the gift. I can change the gift wrapping.
And so I had reached a level now that my
practice is so much heavier in esthetics, facial aesthetics, that
is it would be. It was frustrating not to be
able to provide the totality of what I think a
patient needs in order to get a home run result.
(08:25):
You could do a facelift, you could do their eyelid,
you can do whatever, and then they'd look good, but
they still have crappy skin, they still have a bunch
of sunspots and sun damage. So the areas that we
focused in on is we here in in our met
spot focus on predominantly sun damage right, pigmentary related sun
(08:50):
damage types of things all the way down to melasma,
which technically isn't sun damage but hormone driven, as well
as skin texture, wrinkles, resurfacing pores, things of that nature.
We dabble in the vessels and suns, the rosetia thing
because the laser we have is so broad, but generally
(09:13):
that's the bulk of it. And so after extensive homework,
it became apparent to me that the laser that we
ultimately acquired, in my opinion, currently, as you know, with
the technologies, it's constantly going to change. But I think
that the laser that we got is the Bugatti of lasers.
(09:35):
And why that is is because number one, I think
that consistency of results, meaning it consistently produces fantastic results.
Number Two, it allows us to treat more patients than normal.
So you and I talked about this. A traditional laser
(09:55):
laser energy coming out of a machine was designed for
white people. Not let me rephrase that. It wasn't designed
for white people. It was just that white people were
the only people that could do it. It wasn't like
they went out of their way and they were like, racist,
I'm gonna make a laser only for the white folk. No,
it was just that the technology, because it's heat, only
(10:17):
white skinned people could take advantage of it, because darker
skinned people like me, like you, like Latinos, like African Americans,
like Indies couldn't because they would create a host of
new problems. And so as a result, let's go over
skin coloring. The whole spectrum of skin colors is designed
(10:38):
by is categorized by a term Fitzpatrick. I'm assuming it
was doctor Fitzpatrick. I'm assuming, and we call it Fitzpatrick
scale from one to six. One being snow white, six
being African black. Right, So one, two and some threes
have always been able to do lasers, four five, six
(11:02):
never been able to do lasers. And because my practice
is so heavy in four fives and six is right.
We have Asians, Middle Easterners, Latinos, African Americans, people that
are of Indian descent. I mean shit, eighty percent of
(11:23):
my patients are kids Fitzpatrick four five and six. So
the current technologies in most companies, their lasers don't really
can't really treat four five and six. They just haven't
gotten there. The laser we ultimately decided on, which is
(11:43):
a Syton laser. This is not an ad for Sitan
is really the only one of the only laser companies
that has advanced the technologies such that darker people can
benefit from these lasers. And I think for me, as
a person who has never had a laser, this is
(12:04):
the best time to enter because I now have acquired
a laser that I can do a lot with the
patients that we have. So in the Syton laser world,
they have many lasers. We went ahead and selected what
we felt were the three most critical lasers and we're
going to talk about what they do and who they're
(12:25):
for and what to look for and whatnot. One of
them is a technically not a laser. Yeah, it's called
BBL and I'm not talking about Brazilian butt lifts. It
took me a while. I was like, what butt lifts
are getting into lasers? So Brazilian butt lift slash BBL
is broad band light and what people will know it
(12:48):
as is IPL right, intense pulse light, And what you
had told me about it is that it's just a
flash of light that goes straight through the skin, finds pigment,
explodes pigment, and then the pigment finds its way to
the surface. So historically it was done with IPO, and
(13:09):
Syton came up with their own technology of the in
the intent in the light technology. They renamed it as
broadband light, essentially the same as an IPO. But now
you can start treating higher Fitzpatrick and I think that's
a game changer, right, So tell me about yours. You're
(13:30):
a lighter eight, you're a lighter Asian woman, but you're still.
Speaker 2 (13:34):
A four and I'm still four.
Speaker 1 (13:36):
Exactly what makes you a four is what.
Speaker 2 (13:39):
Well my Asian descent and I'm Filipino, so that in
general we do have more melanocytes in our skins.
Speaker 1 (13:44):
Right, the tanning potential exactly, So people that are white
that tan are not white. That's the key. White means
that when you go to in the sun, you have
no melanocytes, you get red and beat beat, red, lobster,
red peel, and you just don't when you're whitish, and
you go in the sun and you get darker and
(14:05):
you get freckles, then technically you're not a one or two,
you're like a three four. So Charlene's a four, I'm
probably a four, which means that if you know, we
went to you know, Costa Rica for a month, we
probably much darker now you can you and I can't
really do IPL no, And I've.
Speaker 2 (14:23):
You know, I've worked with lasers for maybe fifteen years
and I've tested and IPL myself. I would give myself
a little testpot just to see if I could even
do it, because obviously I want to get the benefits
for a machine that I'm using on other patients. And
I have had some hyper pigmentation and burned from it.
Speaker 1 (14:38):
Yeah, even with the.
Speaker 2 (14:39):
Lowest settings and the safest settings that I think I
could use.
Speaker 1 (14:42):
Yeah. So I think that's the reason why their BBL,
their broadband light siitons is such a game changer, because
you can't treat fives, you can't treat sixes, yeah, but
you can pretty safely address three fours and some five
lighter five, right, And that's that's that's kind of like
(15:03):
synonymous to autonomous driving cars like it's a big leap
in the laser world, wouldn't you say? Yeah?
Speaker 2 (15:09):
Yeah, they were able to integrate these different filters that
can you go to use it with other skin.
Speaker 1 (15:16):
Types, right, So I think that's really really remarkable. So
of course we got that it's not a laser, but
that mode mode. The next mode was we wanted something
that would resurface. Right. So here you are, you come
in for a facelift. You're in your late forties, early
fifties and sixties and beyond, and we're going to tighten
(15:38):
up your skin and pull it and make it snug.
But your skin has now had fifty years of road rash, right,
It's got pores and fine wrinkles in whatever, and so
a perfect time for us to resurface your skin, clean
off the top layer depending on your tolerance. Your tolerance
is during the OAR and so there are two main
(16:01):
technologies CO two resurfacing and erbium resurfacing, Buy and large.
For the average consumer, they're the same, YEA. What that
means is they're ablative, meaning they are burning, burning layers
of skin off. And the laser is so advanced that
(16:22):
I can dial it in by micro nanometer micron microns
and dial it in layer by layer. I'm talking ten
microns one hundred microns, which is insane because it means
that the laser can take a little of the layer off.
And why this I chose the erbium version. Their name
(16:43):
is trol. It just is an erbium resurfacing laser. And
what I love about this laser is that it allows
me to do a you're under anesthesia, you're asleep, you
have no pain, you can't feel nothing. I'm going to
crank up this resurfacing and I'm going to burn the
(17:05):
outer layer of your face off. And the benefit is
A you can tolerate it, because normally you wouldn't be
able to tolerate such a deep resurfacing, and b is
you're down for the count because the number one issue
with all lasers is recovery. So the more aggressive we get,
(17:25):
the more amazing the results, the more downtime you have.
And so when you're having surgery and you're out for
sure for at least a week, we have the luxury
of having downtime. So I am now not only doing
this resurfacing on all my facelip patients. I'm doing this resurfacing.
(17:46):
I did a Mommy makeover on Friday, I resurface the
shit out of her face because frankly, she has no
pain when she's on anesthesia and she's out for a week.
So it's been a game changer in that regard. But
the reason I love this laser is because in addition
to being in the OAR and major downtime and major
(18:06):
outcome is we have a milder versions that you are
now able to do in the clinic with less downtime,
almost no pain, less recovery, and higher skin types. So again,
I think the laser, this particular laser, the Syton laser,
(18:29):
was a game changer because it started giving us tools
to help with all the patients I never were to
be able to. So the two types of peals that
we can sorry, excuse me, the two types of resurfacings
we can do in the clinic side is something that
we just refer to as a nano peal, aka a
very gentle resurfacing, which we can do in black patients that.
Speaker 2 (18:53):
Is nuts properly pre treated.
Speaker 1 (18:56):
Right, We're going to get to the pre treatment and
then we can do something called the micropeel, which is
a more aggressive form which would which we can also
do in certain types of people. So A, we got
the BBL pigment. B we got the resurfacing, which was
a TRL. Now the final game changer was this thing
(19:17):
where now we have what's called a halo. And the
reason the halo is a game changer is it's a hybrid.
It literally takes both of those technologies and wraps them
into one. And what it allows you to do is
sends two wavelengths simultaneously. In one is it penetrates deep
zaps the pigment like the BBL but different, and then
(19:41):
at the same time it resurfaces the top. So in
one treatment with the halo, you get the benefits of
pigment and the resurfacing. And that one is right now
probably the hottest laser on the market. There used to
be a laser Cullt not used to there still is.
There's a laser called Fraxel and Fraxol is the laser
(20:04):
that originated this concept and they were the og of
this technology and for many years they were the main thing.
Like anyone who wanted to get resurfacing of their skin,
they were, you know, in their forties and fifties, even
in their late thirties they'd go get a fraxel. This
(20:24):
technology really is the new iteration and blows the fractional.
Speaker 2 (20:28):
So this laser apart though, is that with the fraxol,
I mean, it is a great technology and you could
still use it today, but you were limited to the
skin types that you had to use it on. You
couldn't treat fives and sixes with that, yeah, maybe even fourst.
But with the halo we can actually even treat up
to a six skin type six yeah.
Speaker 1 (20:45):
Which which again for anyone in the laser world, I
think this idea of even treating darker skinned people is
just like Wow, this is such a game changer. Literally,
it's like it's a revolution in my opinion. So essentially
what we did was we acquired these three modalities. We
have a pure pigmentary light based laser BBL, which we
(21:11):
have a true resurfacing layer that a laser that we
can do from mild moderate severe, oh my god. And
then we have this incredible hybrid laser that we can
do both in one shot. You can do these lasers
in the clinic under numbing cream and you can do higher,
more aggressive ones in the oar under anesthesia. The other
(21:34):
thing about it. That's really cool is that you know
you can stack these treatments so like you can do
a nanopeal and a BBL in one setting and they
work completely differently, and they almost mimic a halo.
Speaker 2 (21:50):
It's for the people who want less downtime. I'd say, yeah,
obviously have to do more sessions than a halo, but
you'll have very little downtime but still get results.
Speaker 1 (22:01):
Yeah. So the key to lasers in general, what I
want you guys to understand first. First thing is I
need to make sure I'm using the right laser for
the right problem. So if you don't know what your
issue is it's pigment, it sprinkles, it's vessels, and you
don't identify that the laser that the place is using
is the best laser for that problem, don't bother going in.
(22:21):
The Next thing you need to decide is how much
downtime am I willing to have? How much downtime am
I willing to have? Understand, more downtime equals better results
the end, there is no laser amazing results zero downtime
that just doesn't exist. The greater the downtime, the better
(22:44):
the results. So your options are a suck it up.
I'm going to take a week off. I'm off for vacation.
My kids are this. I broke my leg. I'm going
in for a breast dog whatever. Go more aggressive, be
done with it, and or I don't have that such luxury.
I work my kids. Do da da do more sessions?
(23:04):
Get there anyways and have lesser down time. Do you
only downside to the more sessions? It's it's more sessions.
The upside is that you don't lose. You don't lose
a beat. Now, the next thing that I think is
super important is that without skincare, do not do lasers.
(23:27):
Without skincare, do not do lasers. I am a prime example.
I did lasers. I did it without skincare. I kind
of was being a little bit of a cavalier and
it didn't work out as well as I like. Because
at the end of the day, I'm still a Fitzpatrick. Four.
I still go outside. I need Thistat the other if
you are white and you are fitzpactors one and two,
(23:49):
you are lucky. You don't need anything. If you are
everyone else in the world three, four, five, six. If
you go in and you just go into a spa
get a laser done to your face and walk out,
you are likely to have more pigment, more sun spots,
more irregularities. Did you hear what I just said? Because
(24:10):
these things are heat driven, and if you don't do
the pre and post skin care, if you are not committed,
if you don't have the whatever it takes, then don't
bother because you have to get the skin ready to
get heated, and then you need the skin to be
treated after it's been heated. Now, it's very mild, it
(24:33):
doesn't take a lot. It's not a major to do.
It's not a huge ordeal. But like, you can't have
a laser and not worse SPF. You just can't. Like
you just forget it, don't go. It's a waste of time.
Not only is a waste of time, I actually think
you get worse. Yeah, you know there's people who have
gone and gotten lasers and then they've gone on vacation
or something and then they're like sunspots that I actually
(24:55):
when I was twenty something, I went in I had
like five hairs on my back and I had my
laser I had. I went somewhere I had my back
hairs lasered off. I was like, oh cool, because my
friend is an idiot and he took me with him
and he's a hairy bear and he lasered his back.
And then like two weeks later we went to Vietnam
and like beach cities. The amount of freckles on my
(25:19):
back right now, actually, as a matter of fact, you
got to be beyond my back. The amount of freckles
on my back is insane. And that was my stupidity.
I didn't use any SPF. So and then that's really
really really important. What can go wrong with lasers. Let's
talk about what can go wrong with lasers.
Speaker 2 (25:36):
So, again, if you're not properly using the proper skincare,
pre treating, post treating, you can definitely get your results
can be worse.
Speaker 1 (25:45):
Pigment, your pigment can skyrocket. Pigment can skyrocket. If you
went in there fix your pigment and you don't get
the right settings, the right pre treatment, the right post treatment,
your pigment could get worse.
Speaker 2 (26:01):
You could get a burn burn.
Speaker 1 (26:04):
So if you are oh, I've been on retinee all
day long, I I you know, you're an acutaine or something,
and you go in there and you get lasered and
you your skin is thin, you can get burned, or
the setting is too high, you can get burned.
Speaker 2 (26:19):
Yeah, absolutely, cold source, cold source.
Speaker 1 (26:24):
So if you are prone to cold source, it's not
a complication, but it's certainly not going to be fun.
And if you get a shingles outbreak, you'll be pissed.
So if you are prone to cold source, any type
of stress, as you know, stress of a flu. I
got COVID. I'm undergoing of divorce triggers these viruses. So
you want to make sure you tell your provider. Hey,
they should be asking you anyways, but hey, I get
(26:46):
cold source, you should take a Voaltrex and a few
and a little bit of medication for a day or
two around the lasers. Those are really the two main
things I think you can get pigmentary changes or burns.
It's pretty much the main, main main issues. We're very
excited about our new laser. To me, it's almost like
(27:07):
it's exciting because it's things that I was never able
to do. And I think that it really is a
cherry on top and this sort of if you will,
the hood ornament on a rolls or a Bentley without it,
it's just sort of an incomplete process. And I'm very
excited that we're able to do this and do it
at a high level now. So listen, we happen to
have this Syton laser. It's not to suggest that other
(27:29):
laser is not good. There's actually a ton of other
great lasers. You just need to become educated. And I
it took me a while to become educated, but I
now know like a Pico Shore, a Piko Shore specific
for this. I want to get my tattoo removed. I
would google best removal tattoo remove a laser, and they
each laser will have a will be really honed in
(27:50):
to do one very specific thing. One thing is for sure,
no laser does it all like there isn't one hand
piece with one wave length. Then you just go in
there and zap off your hair, remove your tattoo, get
rid of suns. It just doesn't work that way. By
the way. Also, we talked about just briefly, and I'll
just touch on this because no, actually we'll do this
(28:12):
in another episode. I was gonna talk about micro needling,
but we'll talk about our f microneedling. But we'll talk
about that on micro needil at any rate, I hope
you found that to be informative. Obviously, it's a very
superficial crash course on lasers. It's sort of what I
think would be relevant for you to know, and hopefully
it was helpful. We're gonna do Our next episode will
(28:32):
be on micro needling, which, if you talk to my wife,
is the wife and charlene favorite treatment in the whole universe.
I would argue that it truly is, and we'll touch
on this whole new world of radio frequency micro needling,
which is RF and things like Morpheus. So anyway, I
hope you enjoyed that episode. As always, two parting favors. One,
(28:55):
if you like the show, go write something sweet, Go
write a review, Go say hey, it was great and
we really do appreciate it. Secondly, send our episode, Send
it to friends, family members. You never know who's gonna
go and do something stupid and foolish and you're like, oh,
I just listened to an episode. I wish you would
have listened to it. You just don't know what's gonna
(29:16):
happen to someone you love, So share, subscribe, and download.
All right, that's a wrap, yet another episode of plastic
surgery and sense it. We'll see you next week. Your host,
doctor Roddy Raban,
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On Purpose with Jay Shetty
I’m Jay Shetty host of On Purpose the worlds #1 Mental Health podcast and I’m so grateful you found us. I started this podcast 5 years ago to invite you into conversations and workshops that are designed to help make you happier, healthier and more healed. I believe that when you (yes you) feel seen, heard and understood you’re able to deal with relationship struggles, work challenges and life’s ups and downs with more ease and grace. I interview experts, celebrities, thought leaders and athletes so that we can grow our mindset, build better habits and uncover a side of them we’ve never seen before. New episodes every Monday and Friday. Your support means the world to me and I don’t take it for granted — click the follow button and leave a review to help us spread the love with On Purpose. I can’t wait for you to listen to your first or 500th episode!